26 13 52 17 46th Tobacco Chemists' Research Conference
26 25 69 28 TH 46 TCRC REGISTRATION FORM
13 29 28 31 Please type or print
13 33 19 34 Name:
24 34 27 35 First
40 34 44 35 Middle
55 34 58 35 Last
13 37 22 38 Institution:
13 40 20 42 Address:
24 42 28 43 Street
40 42 46 43 P. O. Box #
50 46 57 47 ZIP Code
66 46 72 47 Country
40 46 43 47 State
24 46 27 47 City
39 49 48 50 Area Code:
14 49 23 51 Telephone:
14 52 54 54 Name of spouse participating in the guest programs
42 55 51 57 Monday (Y/ N)
58 55 67 56 Tuesday (Y/N)
66 59 73 61 $ 170.00
14 60 51 61 Advance Registration Fee: (prior to August 10)
67 61 74 63 $ $185.00
42 61 45 63 10)
14 61 42 63 Late Registration Fee: (after August
23 63 48 65 Extra banquet tickets @ $ 40.00
67 66 73 67 TOTAL
14 72 83 77 Send this registration form, along with payment to address noted below in attached envelope. Enclose a cheque or international money order payable in Canadian funds to the 46th Tobacco Chemists Research Conference.
41 78 74 86 Ms. Susan Mathison Canadian Tobacco Manufacturers Council 701- 99 Bank Street Ottawa, Ontario, Canada K1P 6B9 (613) 238- 2799
30 78 37 80 Mail to:
85 79 87 86 87682908
